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Inborn errors of immunity (IEI) are characterized by diverse clinical manifestations that are dominated by atypical, recurrent, chronic, or severe infectious or non-infectious features, including autoimmunity, lymphoproliferative disease, granulomas, and/or malignancy, which contribute substantially to morbidity and mortality. Some data suggest a correlation between clinical manifestations of IEI and altered gut microbiota. Many IEI display microbial dysbiosis resulting from the proliferation of pro-inflammatory bacteria or a decrease in anti-inflammatory bacteria with variations in the composition and function of numerous microbiota. Dysbiosis is considered more established, mainly within common variable immunodeficiency, selective immunoglobulin A deficiency, severe combined immunodeficiency diseases, Wiskott-Aldrich syndrome, Hyper-IgE syndrome, autoimmune polyendocrinopathy-candidiasis-ectodermal-dystrophy (APECED), immune dysregulation, polyendocrinopathy, enteropathy X-linked (IPEX) syndrome, IL-10 receptor deficiency, chronic granulomatous disease, and Kostmann disease. For certain IEIs, the specific predominance of gastrointestinal, respiratory, and cutaneous involvement, which is frequently associated with dysbiosis, justifies the interest for microbiome identification. With the better understanding of the relationship between gut microbiota, host immunity, and infectious diseases, the integration of microbiota modulation as a therapeutic approach or a preventive measure of infection becomes increasingly relevant. Thus, a promising strategy is to develop optimized prebiotics, probiotics, postbiotics, and fecal microbial transplantation to rebalance the intestinal microbiota and thereby attenuate the disease activity of many IEIs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hazime, Eddehbi, El Mojadili, Lakhouaja, Souli, Salami, M’Raouni, Brahim, Oujidi, Guennouni, Bousfiha and Admou.)

Large amounts of secondary date waste (pulp and seeds) are produced and discarded in Tunisia without proper valorisation methods. To study the possibility of valorising different varieties of Tunisian date waste (pulp and seeds) via anaerobic digestion, batch biochemical methane potential (BMP) tests were carried out under mesophilic temperature. The bio-methane production curves were fitted to the model of modified Gompertz in search of the kinetic parameters. The bio-chemical characterisation of the substrates from different varieties (total and volatile solids, COD and contents in carbohydrates, proteins, lipids, polyphenols) was realised. Principal component analysis (PCA) was used to investigate the correlations between the model parameters and biochemical variables. Results show that the biochemical compositions of date pulp and seeds strongly depend on the varieties. The BMP are in the range of 0.295-0.345 and 0.267-0.327 Nm 3 CH 4 ·kg COD -1 for pulp and seeds respectively, resulting from the significant biochemical variance among the varieties. The BMP of date seeds was significantly correlated with their VS/TS ratio, carbohydrate and protein contents ( p  < 0.05). For the pulp, significant correlation was found between BMP, carbohydrate and lipid contents. PCA shows that certain varieties (like pulp and seeds of Deglet Nour and seeds of Bejou) are most suitable for being valorised by anaerobic digestion. The most suitable date varieties for this innovative approach were revealed. This research provided useful knowledge for bioconversion of waste date pulp and seeds to biomass energy.

Introduction: Total cystoprostatectomy (TCP) causes many changes in the postoperative quality of life leading to psychological, physical, social and sexual repercussions that are difficult to manage. This study aims to describe the postoperative quality of life of elderly Tunisian men who had a TCP as a result of a bladder cancer., Methods: A descriptive quantitative study was conducted with 40 cystoprostatectomized men. Data collection tools were the Stoma-quality of life (QOL) questionnaire of Prieto, Thorsen, and Juul (2005) translated and validated to the Arabic language, and the Arabic version of the International Index of Erectile Function (IIEF5) questionnaire validated by Shamloul, Ghanem and Abou-Zeid (2004)., Results: 77.5% of participants had a very low quality-of-life score. All dimensions of quality of life-body image, physical, psychological, family and social life, and sexuality-were affected. In addition, all participants have suffered from severe sexual impotence after surgery., Conclusion: Counselling pre and postoperatively needed to facilitate the postoperative transition and ensure a better quality of life related to the health of men with bladder cancer., (© 2019 Canadian Association of Nurses in Oncology (CANO).)

Introduction: We wish to integrate an adverse events reporting system in a Tunisian University Hospital. However, before the implantation of this system, it is important to identify the factors that may influence the reporting, so it is primordial to conduct a study which aims to determine influencing factors of adverse events reporting according to the perception of health care professionals., Method: A cross-sectional descriptive study was conducted between July and September 2014, using a questionnaire which was developed in the light of Reason&#8217;s works on safety culture (1990; 1997), and the Pffeifer, Manser and Wahner (2010) model of influencing factors of adverse events reporting. This questionnaire was self-administered to 46 physicians, 21 health technicians, 65 nurses and 18 practical nurses working in a Tunisian Hospital. Data analysis was conducted using SPSS., Results: The main obstacles identified were: lack of staff training (78.7%) and lack of precision on the types of events reported (76.7%). However, the three main facilitators are the establishment of a safety culture (88%), the commitment of decision makers in the safety culture (81.3%) and the absence of punishment (78, 7%)., Conclusion: A policy and managerial consideration of the main factors influencing reporting of adverse events, as well as suggestions from health professionals, is necessary to ensure a good adoption of the reporting system by healthcare institutions in Tunisia.

Graphene is susceptible to morphological instabilities such as wrinkles and folds, which result from the imposition of thermo-mechanical stresses upon cooling from high temperatures and/ or under biaxial loading. A particular pattern encountered in CVD graphene is that of mosaic formation. Although it is understood that this pattern results from the severe biaxial compression upon cooling from high temperatures, it has not been possible to create such a complex pattern at room temperature by mechanical loading. Herein, we have managed by means of lateral wrinkling induced by tension and Euler buckling resulting from uniaxial compression upon unloading, to create such patterns in exfoliated graphene. We also show that these patterns can be used as channels for trapping or administering fluids at interstitial space between graphene and its support. This opens a whole dearth of new applications in the area of nano-fluidics but also in photo-electronics and sensor technologies.

Purpose: Patient decision-aids (PtDAs) help patients make informed treatment decisions incorporating their values. Health-related quality of life (HRQOL) is sometimes an outcome of PtDA effectiveness trials, but its suitability for this purpose is unclear. We sought to provide insights into this question by critically appraising how randomized controlled trials (RCTs) evaluating PtDA effectiveness measure and report HRQOL., Methods: We conducted a sub-analysis of RCTs included in the 2017 Cochrane review of PtDAs. Trials assessing HRQOL at baseline and post-PtDA, and comparing PtDA with comparison groups were included. Two reviewers independently extracted data and assessed study quality. Analysis was descriptive., Results: Of 105 RCTs, 11 were eligible for inclusion. Patients randomized to PtDAs did not report better HRQOL than those randomized to usual care. While all 11 RCTs adequately described baseline sample characteristics and reported HRQOL results for study groups, few stated a priori HRQOL expectations or hypotheses (36%); made a link between HRQOL and the decision (18%); provided a rationale or justification for HRQOL assessment (18%); provided reason for choice of HRQOL assessment time-points (9%); or adjusted p-values for multiple HRQOL domains and time-points (0%)., Discussion: PtDAs did not conclusively impact HRQOL. If this holds generally, then HRQOL is an uninformative endpoint for PtDA effectiveness trials. When planning trials of PtDAs, investigators considering HRQOL endpoints should consider whether and why their PtDA is likely to affect HRQOL in their context, and if so, which specific aspect(s) of HRQOL and at which time-point(s), and ensure HRQOL is assessed accordingly.

Arid and semiarid regions with rain shortage and scarce good quality water must make use of low-quality water for irrigation. Consequently, improved plant cultivars for use in these areas should show adaptation capacities to confer drought and salt resistance and allow the cultivation under limited water availabiltiy. The present study was conducted to determine the effect of deficit irrigation with saline water on two local barley landraces, "Karkeni" and "Bengardeni". Plants were saline-irrigated with three watering regimes during tillering, heading, and grain filling stages. Biochemical traits, carbon isotope discrimination (Δ 13 C), mineral composition, grain yield (GY) and water use efficiency based on grain yield (WUE gy ) were evaluated as performance indicators. Almost all of the studied traits (e.g. soluble carbohydrates, proline, ∆ 13 C, Na concentration, and GY) were significantly affected by deficient saline-irrigation regimes at different growth stages. The hierarchical clustering analysis clearly showed that Δ 13 C placed very close to GY averaging two barley landraces, which was in accordance with the scatter plot result. Multiple linear regression performed between GY as the dependent variable and other traits studied as the independent variables indicated that WUE gy , Δ 13 C, and soluble carbohydrates significantly explained the variability in GY ( R 2 =95.64%). A significant positive correlation that observed between ∆ 13 C and GY at three growth stages, indicated that ∆ 13 C may be an important proxy component for indirect selection of yield potential in barley under deficient irrigation regimes with saline water. According to our result, "Karkeni" seems to be more efficient in terms of higher GY, WUE gy , proline and carbohydrate contents, K, Mg and Zn concentrations, as well as lower Δ 13 C and lipid peroxidation as compared with "Bengardeni", under low osmotic potential imposed by deficient irrigation treatments with saline water, "Karkeni" can thus be selected and used as a parent in order to obtain more tolerant plants against such stresses in future breeding programs., (© 2018 The Japanese Society for Plant Cell and Molecular Biology.)

Regular assessment of risk of violence is shown to be effective in reducing violence in mental health services., Purpose: To evaluate health care providers' use of a violence risk assessment tool on a mental health unit and the facilitators for and barriers to its use., Methods: A descriptive study using the Dillman approach and informed by the Knowledge to Action framework was conducted., Results: Twenty-six health care providers responded to the survey; 62% reported using the violence risk assessment tool available on their unit, but not on a daily basis. Common barriers were lack of knowledge of the tool, lack of resources and time, and negative attitudes toward patients. 42% of participants indicated the need for further training on violence risk assessment., Conclusion: Despite high exposure to violence, health professionals were not conducting daily risk assessments. The barriers and facilitators identified provide direction for interventions that are necessary if the daily use of violence risk assessment tools is to be increased.

Objectives: To evaluate and to compare the predictive accuracy of the Wells score and the revised Geneva scores for the diagnosis of pulmonary embolism in the pregnant and postpartum population., Study Design: All pregnant or post-partum patients with a suspected PE and for whom a diagnostic imaging testing was performed (VQ scintigraphy or computed tomography pulmonary angiography) over a 3-year period were included in the study. The Wells and Revised Geneva Scores were calculated on the same cohort of patients and dichotomized into low and intermediate/high probability groups. The sensitivities and specificities were calculated. Overall accuracy was determined using receiver operator characteristic curve analysis., Results: A total of 103 patients were included. The overall prevalence of PE was 26.2% (27/103). Using the Wells Score, the prevalence of patients with PE in the low, intermediate and high probability categories was 20.5%, 43.5% and 50% respectively. Using the Revised Geneva Score, the prevalence of patients with PE in the low, intermediate and high probability categories was 17%, 36.2 and 33.3% respectively. In low risk groups of the Wells score and the simplified revised Geneva score the prevalence of PE was not statistically significantly different: respectively: 20.5% and 17.5% (p = 0,232). The agreement on clinical assessment using the Wells score and using the revised Geneva score was weak (κ coefficient = 0.154). In total, 26 (25.2%) patients were classified differently using the 2 scores. There was no significant difference in the overall accuracies of the Wells (0.67, 95% CI 0.54-0.79) and Revised Geneva Scores (0.64, 95% CI 0.52-0.76) as determined by the area under the ROC curves (P = 0.628). The sensitivity, specificity, PPV and NPV of the Wells score and the revised Geneva score were respectively: 40.7%, 81.5%, 44%, 79.4% and 62.9%, 59.2%, 35.4%, 81.8%., Conclusion(s): The Wells score and the revised Geneva seems not to be valuable in the pregnant and post partum population. A specific risk score of PE for pregnant and postpartum population is needed to reduce the rate of unnecessary imaging studies, especially in this specific population were the use of radiation and contrast agent is problematic., (Copyright © 2017 Elsevier B.V. All rights reserved.)